Micro, Small and Medium Enterprises (MSMEs) are significant contributor to the economy. This study examines the growth of MSMEs and their role in provision of employment to people in Upper Assam. The study is based on secondary data collected from various sources such as the Annual Survey of Industries, the Statistical Handbook of Assam, and reports from the Reserve Bank of India and the Ministry of Micro, Small, and Medium Enterprises. It analyses the growth of MSMEs in the State during the period 2000–01 to 2018–19 and also investigate the pattern of employment and its trend in MSMEs. The findings of the study revealed that there has been a significant growth in the number of registered MSME units in the State. The number of registered MSME units in Assam increased sharply from 14,453 in 2000-01 to 48,171 in 2018-19. The compound annual growth rate (CAGR) in number of registered MSME units during the period 2000-01 to 2018-19 was found to be 6.54 per. The found differences in growth of investment, employment trends and number of registered MSME units in seven districts of upper Assam. In most districts, employment in MSMEs has grown slowly as compared to growth in number of units. In fact, there has been decline in employment per unit. Additionally, the average investment per unit differed considerably among the districts, indicating that MSMEs in some districts have varying investment capacity and patterns. The results point to the need for focused approaches to reduce regional differences and improve employment prospects by promoting investment for reducing unemployment and achieving balanced industrial growth in Assam.